Gonorrhoea, a sexually transmitted infection also referred to as “the drop” or “the clap”, is known to increase the risk of HIV transmission. With growing resistance to antibiotics, effective screening and treatment of gonorrhoea is becoming a priority among high-risk groups like men who have sex with men.
Concern is mounting that resistance is now developing to the antibiotic cefixime recommended by the South African Department of Health for treating gonococcal urethritis.
Currently, diagnosis and treatment at government clinics is based on a syndromic approach, meaning treatment is based on observable clinical symptoms rather than laboratory tests.
As a result clinic staff have no way of knowing whether the particular strain of gonorrhoea is resistant to certain antibiotics, making treatment failure likely.
Gonococcal resistance is more common among men who have sex with men (MSM) than heterosexual men.
Following the diagnosis of two cases of multi-drug resistant gonorrhoea among MSM in Johannesburg by Dr David Lewis of the National Institute of Communicable Diseases, the Anova Health Institute, through its Health4Men programme, has initiated enhanced screening for MSM at its Ivan Toms Centre for Men in Cape Town.
A third case of drug resistant gonorrhoea has subsequently been identified in Cape Town.
Dr Kevin Rebe from the Anova Health Institute’s Health4Men advises: “This is an important concern because the current South African STI syndromic treatment guidelines will not identify drug resistant gonorrhoea and resistant strains could be spreading among vulnerable key populations without being detected. This could negatively affect our STI health programmes in future.”